A statement from the Ministry of Health yesterday said those who have to pay the extra premiums have serious conditions that need intensive medical intervention to treat or manage; or have high risk of future complications or recurrence that could require prolonged treatment.

The reason they need to pay only 30 per cent more for 10 years is that the MediShield Life Review Committee has spread the cost of including this group of high-risk people among everyone else and the Government. As a result, everyone pays up to 3 per cent higher premiums, with the Government underwriting the remaining extra cost.

People who develop such medical conditions after they have bought MediShield or a private integrated plan are not deemed to have a pre-existing illness.

Health Minister Gan Kim Yong said in the statement that his ministry has "taken a fair and compassionate approach" in identifying those with pre-existing illnesses. Someone with well-controlled diabetes, for example, is exempt.

He said of the 25,000 people identified: "Most of them would not be able to purchase insurance and would have been bearing high medical costs without any insurance protection over the past years. With MediShield Life, they can now be covered for life and receive help with their large medical bills."

On top of that, if they are among the two-thirds of people entitled to premium subsidy, the 15-50 per cent subsidy will be extended to the 30 per cent extra they need to pay because of their pre-existing illnesses.

There is additional financial help for those who still have difficulty paying the premiums after getting Medisave top-ups and the subsidy.People who have MediShield or a private integrated plan will receive letters when their current insurance is due for renewal, giving them details of their new premiums and the subsidies they will get.

Those with no health insurance will receive letters next month, as they will be covered when the scheme starts in November.